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Disability progression in multiple sclerosis patients using early first‐line treatments

Authors :
Mathilde, Lefort
Sandra, Vukusic
Romain, Casey
Gilles, Edan
Emmanuelle, Leray
Chantal, Nifle
Centre d'Investigation Clinique [Rennes] (CIC)
Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Centre de Recherches sur l'Action Politique en Europe (ARENES)
Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
CHU Pontchaillou [Rennes]
Département Méthodes quantitatives en santé publique (METIS)
École des Hautes Études en Santé Publique [EHESP] (EHESP)
Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL)
Université Claude Bernard Lyon 1 (UCBL)
Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Service de Neurologie [Lyon]
CHU Lyon
Fondation Eugène Devic EDMUS
This work was funded by the Eugène Devic EDMUS Foundation against Multiple Sclerosis and by the ARSEP Foundation (Fondation pour l'Aide à la Recherche sur la Sclérose en Plaques)
Université de Rennes 1 (UR1)
Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Source :
European Journal of Neurology, European Journal of Neurology, 2022, 29 (9), pp.2761-2771. ⟨10.1111/ene.15422⟩, European Journal of Neurology, Wiley, 2022, ⟨10.1111/ene.15422⟩
Publication Year :
2022
Publisher :
Wiley, 2022.

Abstract

International audience; BACKGROUND: Therapeutic management of relapsing-remitting multiple sclerosis (RRMS) has evolved towards early treatment. The objective was to assess the impact of early treatment initiation on disability progression among RRMS first-line treated patients. METHODS: This study included all incident RRMS cases starting interferon or glatiramer acetate for the first time from 1996/01/01 to 2012/31/12 (N=5,279) from ten MS expert OFSEP centers (Observatoire Français de la Sclérose en Plaques). The delay from treatment start to attain an irreversible Expanded Disability Status Scale score of 3.0 were compared between "Early" group (N= 1,882; treated within 12 months following MS clinical onset) and "Later" group using propensity score weighted Kaplan-Meier methods, overall and stratified by age. RESULTS: Overall, the restricted mean time before reaching EDSS 3.0 (RMST) from treatment start was 11 years and two months for patients treated within the year following MS clinical onset and 10 years and seven months for patients treated later. Thus, early treated patients gained 7 months (95% CI: [4-11] months) in the time to reach EDSS 3.0 compared to patients treated later (treatment start delayed by 28 months). The difference in RMST was respectively six months (95% CI: [1-10] months) and 14 months (95% CI: [4-24] months) in the "≤40 years" age group and in the ">40 years" age group, in favour of early group. . CONCLUSIONS: Early treatment initiation resulted in a significant reduction of disability progression among patients with RRMS, and also among older patients.

Details

ISSN :
14681331 and 13515101
Volume :
29
Database :
OpenAIRE
Journal :
European Journal of Neurology
Accession number :
edsair.doi.dedup.....c8f5392f415dfe588edb91ee04b50ec4